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Friday, September 19, 2014

Joan Rivers (from the Broad Street Review)

Remembering Joan Rivers (three)

The person and the persona

I grew up with Joan Rivers. There she’d be on The Merv Griffin Showtalking about her husband Edgar as if he was a homely guy sitting at home in a pair of flannel pajamas waiting for her to give his life meaning. In those early days, Joan was always saying Edgar this and Edgar that, enough to make my boy’s mind wonder why she always made out Edgar to be so ugly and unexciting. Here she was, the undisputed Queen of Comedy — presumably she could have any man in the world — and yet the only thing she wanted when it came to love was Edgar, who by all accounts was the human version of a comfortable but ratty old shoe.
Rivers in a 1967 publicity shot
Of course, in those days I was far too young to understand the comedy of self-deprecation and put-down. All I knew is that on TV Joan Rivers didn’t look half bad. I loved her blow-dried blond hair and sparkling white teeth, a far cry from, say, the brunette Carol Burnett with her undistinguished, Vivian Vance housewife locks. Hollywood blondes like Kim Novak, Barbara Nichols, and Mamie Van Doren for me in those days were always special, although my adolescent love for Lauren Bacall came out one day when, watching Merv Griffin again with Mom, I blurted out, “I love Lauren Bacall. She is so masculine!”
 “She’s what?” my mother asked, sitting straighter on the sofa. “What did you say?”
While Joan certainly had gutsy attributes like Bacall, she was certainly not like all those early male comedians — from Don Rickles to the once hilarious Richard Pryor — who seemed to fade into unfunny obscurity long before their deaths. Joan seemed to know that living life is often hard work and that being a celebrity is no insulation against life’s slings and arrows. People may treat you like a goddess onstage, but in your personal life you are just like everybody else: a vulnerable human being.
Lies and betrayal
In an interview with a psychologist, she confesses that the life pain she’s struggled with most has to do with feelings of personal betrayal.
Her husband’s suicide — secretly well planned, but a shock to her — was a betrayal. In the interview, she says she still hasn’t gotten over her anger with Edgar for this act of duplicity. She explains how Edgar made good-bye videotapes to family members, and then, before he went off to kill himself, he told Melissa, their daughter, that he was only going away for a night and that he would see her the next day.
It was a lie, Joan tells the psychologist. He told my daughter a lie, and now I am worried for her. She will grow up thinking that every man is a liar. And when he died he left me with a fabulous mansion, but I was alone with no show and no contract, and I was miserable. I wanted to die, too, she said.
But if anybody knows Joan Rivers, it is Melissa. Melissa became the new Edgar, the caretaker, the tower of strength behind the scenes. And Joan, the talented perfectionist, was undoubtedly impossible to live with. “Imagine being under her scrutiny all the time,” a friend of mine commented a day after Rivers’s death. “Imagine the pressure and stress of that.”
Presenting a perfect face
When I first set out to write this piece, my idea was to expound on Joan’s addiction to plastic surgery. I somehow equated her plastic surgery obsession to her belief that in life there’s only the here and now. As she told the psychologist, she didn’t believe in an afterlife — “This is it!” she insisted (with theological certainty), which meant of course that she had to make “this” absolutely the best world possible — at any cost, but if that didn’t work (those unavoidable human betrayals again), she might be tempted to end it all herself.
But there’s also this: Joan was like the jester whose job it was to keep the royal court entertained, regardless of how or what she was feeling inside. The job that she had to do — conquering feelings of personal sadness so that they wouldn’t show onstage — meant that she had to continually perfect her face because that face had become the mask of comedy itself.
While there was a lot of rage and rawness in her late comedy routines — for many, Joan went into cesspool realms — that anger, I think, was always fueled by love, as well as a sense of disappointment, in life and in her perception that there’s no redemption anywhere, even in the act of comedy itself.
 How can anyone not get angry when, as Peggy Lee once sang, is that all there is?

Thursday, September 18, 2014


RJ, the homeless guy who opens doors for people at the local WAWA, looks like an Orthodox monk. I've never told him this, but this realization dawned on me a few weeks ago as I made my way along Aramingo Avenue, suitcase in hand, on my way to the bus station in Center City.
Monks were on my mind because I was on my way to my favorite monastery mountain retreat, Saint Tikhon's, for my annual three-day retreat. Saint Tikhon's is located three-plus hours outside Philadelphia, near the Scranton area. I say "near the Scranton area" because the monastery is so isolated that it takes another 40 minutes by car to get to it. When you travel there by bus, a monk usually meets you at the Scranton station and then drives you to the monastery, some 24 miles away.
But back to RJ: RJ has been holding doors at WAWA for customers for quite some time. Sometimes the police chase him away, but often they leave him alone, and why not? He's polite, intelligent, even somewhat educated (he has a military background), and he never begs for money. Because he's homeless, he sleeps near the columns of I-95 along Richmond Street, on slats of cardboard.
RJ is a survivor among the homeless who call the I-95 area home. He's slept there in the dead of winter and on scorching-hot summer nights full of insects, rats and vermin. I've seen him nearly frostbitten, sunburned, sweaty and in need of a bath. Sometimes he'll disappear for a couple of months -- for the reason, you'll have to ask him -- but he always returns. RJ is the man with nine lives, or maybe even 20.
There are times that RJ seems optimistic about getting his life together. (Without giving away the man's secrets, he knows what he has to do in order to accomplish that!) In fact, the next time you see him, you may want to ask him about that. It's not a crime to talk to a homeless person. You won't catch cooties, crabs, Ebola, a fainting episode or even HIV. In fact, you might even learn something.
When I saw RJ while on my way to the bus station, I was half-tempted to say, "RJ, I think I have the life for you. You need to leave the city for at least a year. You need to live far away from the city and all its temptations until you are really on your feet. And a monastery is the perfect place for that."
Of course, with his black beard, RJ would fit right into Saint Tikhon's. He could still hold doors, but he could switch from holding WAWA doors to holding the Royal Doors in the church during Divine Liturgy.
Although RJ may look like a monk, living the life of a monk is hard stuff. Monks don't sneak away to private beer bashes on the weekends; there are no intoxicated late nights at Johnny Brenda's, no waiting for a neon taxi cab under the El at 2 in the morning, and there are certainly no girlfriends or boyfriends to cuddle up to.
For RJ to become a monk, he would have to become another person. It would take a huge act of will. It would mean giving up all personal desires and putting his life choices and direction under the care of a father superior, in this case the abbot. For someone over 30 this can be a very difficult thing to do. "Older" men who enter the monastery often have a rough time of things, because it's difficult taking directions and "orders" from a much younger man who ends up being your superior. As one monk told me, "It's better to enter a monastery when you are really young. That way you come into formation gradually. Older men have a very tough time adjusting."
But if RJ were to have a vision like Saul of Tarsus and decide to change his life and become a monk, he'd have to spend at least six hours a day at prayer. That's a lot of church time. Most people are not that concentrated on God. Besides prayer, monks have their work assignments. Each monk has a specific job to do. Brother Basil, for instance, is Saint Tikhon's handyman and carpenter. He can build and fix anything, from bathroom sinks to roof leaks to warped wood paneling. He's also a former evangelical Protestant who found his way to Saint Tikhon's several years ago. I first met Brother Basil when he was fixing a leak in the Guest House kitchen. He was stretched out on the floor in his black robe, a massive tool belt draped over him like a prayer rope.
Then there's Father Silouan, another convert from Protestantism, who looks to be about 28. Father Silouan is not a priest, but after a while the monks at Saint Tikhon's are all called "Father." Father Silouan is an iconographer. He's a soft-spoken guy but a pretty mean driver when he gets behind the wheel of a car. It was Father Silouan who picked me up at the bus station in Scranton and then drove me the additional 24 miles to the monastery. We talked about icons during the car trip. I told him about an old Russian icon of the Last Supper I'd found in an antique shop in Center City and how I'd bargained for a fair price. Icons, even cheap icons, can be ruinously expensive, but I was able to purchase this large, late-19th-century icon for $125.
As a postulant, RJ wouldn't wear a religious habit, but he would live the life of a monk, getting up at 5 a.m. and so forth, and then in between his duties he'd find that he'd have a lot of time to think about the life he was leaving behind. I imagine that this feeling of thinking about the life you have left behind must be a lot like the feeling you get when you are 30,000 feet above the Earth in a jetliner: It's at those times that you tend to think about your life "back there" (on the ground), possibly even seeing it more objectively.
The monks at Saint Tikhon's wear their habits all the time, even when they go home to visit their families. This means they wear their black cassocks and hats when they board airlines, walk through cities, take taxis, go food shopping or visit Home Depot. There's no embarrassment about being a monk, so you won't find these guys donning blue jeans, Bermuda shorts, or a pair of Dockers. Unlike many monks in the West (those swinging Franciscans and Benedictines), Orthodox monks don't go the down-low route and dress in colorful neckties and slacks when on the road. Orthodox monks are men in black 24/7.
At Saint Tikhon's, RJ would discover that one of the challenges in a monastery is making good use of alone time, especially when there are no city temptations around to escape to -- no WAWA doors to open, and no dancing in the bright lights of Aramingo Avenue. At Saint Tikhon's, each monk has at least four or five hours of free time after the early-evening meal. Your activity choices at that time include visiting other monks, special projects, reading (the library is large), meditation or prayer, and walking through the woods, where you risk the likelihood of running into deer (safe) or a bear (not safe).
This is not the high life of the passions by any means, but for many it is a good one.
As for monastery food, RJ would discover that it is mostly delicious and vegetarian. He would also discover that there are a lot of fasts when you are an Orthodox monk. Despite the fasts, he would learn that the monastery refrigerator and kitchen are filled to capacity with a zillion yummy things, from yogurt and cakes to ice cream, but that the monk's job is to self-regulate when it comes to food consumption. As one monk confided to me, "The refrigerator here is a powerhouse of goodies, but the basic idea is self-control. This is especially true when it comes to controlling the passions."
Ah, yes, the passions! I wanted to know about this when I asked a new monk, who hails from Naples, Florida, why I saw young and healthy monks serving themselves tiny amounts of food at supper and dinner. Are they sick? Fasting? Doing penance? But the monk from Naples told me that taking little food is a way to beat the temptations of the flesh. This piece of monastic wisdom, apparently, goes back centuries.
Now, while I realize that RJ may never become one of the men in black -- few men can hope to attain this -- I do hope that he graduates soon from the WAWA School of Holding Doors.

The Book Launch as Info-Commercial

Philadelphia’s Dr. Mütter and his marvels

Weekly Press
• Wed, Sep 10, 2014
By Thom Nickels
Contributing Writer

The Mutter Museum is the talk of the talk of the town these days. Although it was always on the city’s radar of extraordinary places to visit, it has never been as popular as it seems to be today.

Adding to the museum’s popularity is a new biography of Thomas Dent Mutter, by Philadelphia born Cristin O’Keefe Aptowicz, Dr. Mütter’s Marvels: A True Tale of Intrigue and Innovation at the Dawn of Modern Medicine (Gotham Books). Aptowicz, a New York University grad, has garnered a reputation as a good slam poet in the New York City slam poetry scene, although she currently lives in Austin, Texas.

Although the subculture world of the poetry slam is a mixed bag of verbal insanities, I did not expect an unorthodox lecture at the museum when I went with a friend to hear Cristin speak about Thomas Mutter. Of course, it should be noted that it was my first time in the museum in years.

In years past that I would come away from the Mutter with a strange sense of inner paralysis bordering on depression, as if some energy in those bottles and vials had reached out and caused me to feel lousy about life and people. In my more rational moments, I dismissed this all as superstition.

At the Mutter this time to hear Aptowicz, I’d forgotten about those unpleasant experiences. Guests were treated to an appetizing reception in the museum’s main hall. Clearly, much of the author’s family was present, even children, and the overall vibe was happy and enthusiastic, in stark contrast to all those hidden bottles of specimens (and death) in the museum’s back rooms.

I was looking forward to hearing about the Virginia-born Thomas Dent Mutter, who graduated from the University of Pennsylvania before he became a professor of surgery at Jefferson Medical College. Thomas Mutter’s massive medical research specimen collection became the basis for the museum’s founding in 1863. I need not list all these medical marvels, but among them you will find the body of the soap lady; a nine foot long human colon, preserved random human organs and body parts, and the skeleton of a dwarf and a giant. And this, of course, is just the beginning.
But who was Dr. Mutter, really? What did he think and what did he believe? Was he married with children? Was he a Freemason? When and how did he die? But most importantly, how did the museum come to be established? I was hoping the lecture would be a Whitman’s Sampler of information bits.

The mostly upbeat crowd—there were lots of giggling girls although the children present did not misbehave—almost filled the strikingly attractive lecture room. Aptowicz was introduced by her husband, always a nice thing, but she wasn’t anything like I expected. I suppose I expected a tall, regal woman like Gretchen Worden (1947-2004), the museum’s curator in 1982 until her appointment as Director in 1988. Aptowicz’s likeable ham-it-up persona—one could easily imagine her talking up a Julia Child cookbook—made me understand, in a way, the chorus of gigglers I had heard earlier.
Clearly, this was not going to be a conventional talk on Dr. Mutter’s life but instead it would veer off into the unpredictable, most notably into the loose ended come-what-may world of slam poetry, with three guest readings by friends of the author, one of them a slam poet military paratrooper who, as it turned out, looked more like an accountant.
By the talk’s end, I only learned two things about Mutter, the first being that he was the first to advocate anesthesia during surgery; the second being that he was the first physician to come up with the idea of a recovery room after surgery. Aptowicz did touch very briefly on Mutter’s time in Paris (to bring back medical ideas) but after that the talk became an info-commercial on the author’s life.

The info-commercial went as follows: how a portion of the book was excerpted by The Atlantic Monthly; a report to the audience on a rave review in The Wall Street Journal; how the author obtained a 2011 National Endowment for the Arts Fellowship for Poetry; how she landed a 2013 Amy Clampith Residency; some references to her six books of poetry; how she was named a University of Pennsylvania Arts Edge Writer in Residence, and her being given a Francis C. Wood Institute Travel Grant to support her work on the book. The guest readers, in keeping with the surrealist come-what-may dynamics of a poetry slam, read sensationalistic excerpts from 1800 medical texts, while one reader beautifully acted out a scene of hospital gore, after which there was a round of giggly applause.

At the delightful reception, Aptowicz’s mom told me that she had great hopes that one of those Long Island wealthy simmer vacationers reading The Wall Street Journal’s review of the book were hopefully thinking of producing Aptowicz’s screenplay on Dr. Mutter, a 2003 award winner at the Philadelphia Film Festival.

"Plus, you know, Mom added, "she was on Marty Moss-Coane earlier, and she’ll be at the Free Library later this month."
"All of this is super fabulous," one might have answered. "Kudos and accolades and laurel wreaths to your wonderful daughter, but can you tell us where to go to find out something about Thomas Dent Mutter?" (It didn’t help, of course, that when I gave my card to the Texas writer—ostensibly asking to interview her—she immediately directed me to her marketing person, after first directing me to her agent, who looked like Ann Coulter.)

Out on the street, my head reeling with info commercial data, I only wanted to go home and go to bed.

Tuesday, September 2, 2014

Why Hospitals and Surgeons are Sometimes Suspect

The Local Lens

• Wed, Aug 27, 2014

By Thom Nickels

While hospitals are generally places for healing, sometimes—unfortunately-- the reverse is true.

An older woman friend of mine, for instance, talked about a lung biopsy she underwent in a large Center City mega hospital. For quite a while this friend had been having disagreements with her doctor on whether to remove half her lung or to treat her condition with antibiotics. Having half your lung removed is a life altering procedure, so there should be an iron clad reason for doing so. My friend felt that her doctor didn’t have a good enough reason for removing half her lung, so she kept telling him no thank you. In addition, she felt he was far too ‘knife happy,’ almost as if opening the human body and removing organs had become his obsession. In one instance, the knife happy surgeon even told her, "I’m going to get your lung one of these days!" as if he were a vampire or a ghoul.

Life occasionally takes unexpected turns, and that’s what happened when my friend underwent a lung biopsy by the surgeon in question. Now, a biopsy is just a mission in search of a tissue sample, nothing more, so the idea of it didn’t seem complicated until someone in the operating room made a mistake. During the biopsy, the surgeon, or his accompanying resident, nicked her lung, meaning that another surgical procedure was needed to fix the problem.

The operating room team knew about the nicked lung at the conclusion of the operation because they wrote specific instructions on the patient’s chart that she was not to have any solid food because another procedure was immediately pending.

Do you think the floor staff read the doctor’s instructions? My friend was fed solid food, and as a result she could not be given an anesthetic for the second go-round but instead had to endure the feeling of a surgical knife cutting into her skin and into the skin’s deeper sub strata layers so that they could uncoil a tube inside her.
The flimsy local anesthesia that she did receive did nothing to mask the pain caused by the deep digging surgical knives.

My friend described the pain as "unbearable."

But her odyssey didn’t end there. Once the procedure was over, she told me that she wasn’t given enough pain medication, and that she had started to bleed all over the sheets. When she rang for a nurse to change the sheets and also to request more pain medication, nobody came. She waited for a time and rang again, but the response was still the same—nothing. Finally, after giving it one more shot (she pressed down hard on the call button this time), she disconnected herself from a wire holding her to the bed and walked to the nursing station herself, a sight for sore eyes in her bloody hospital Johnny.

Once at the nursing station she let the little circle of telephone yapping-folder filing personnel, have it.
I will not repeat here what she said, except to say that the thunder and verve of her scolding got results fast. Suddenly, the nurses couldn’t do enough for her. Would she like to be escorted back to her room in a wheelchair? Would she like a Krispy Crème donut? And yes, her bed sheets would be changed immediately.

Later, a nurse appeared at her bedside, practically in tears, apologizing for the neglect of the general staff and telling her that she would report the neglect to the floor supervisor. "This is awful, really awful," the good nurse kept saying. "I’m so sorry. Heads will roll!"

The hospital in question is a big city hospital. I remember this hospital from childhood, because a classmate of mine in the 8th grade died there.

His name was Richard H., and he died of a brain tumor after being sick for what seemed like a short while. The tumor came on quickly. Richard had several surgeries, would come back to school with his head in bandages-- on the road to recovery, we thought-- but then in no time he’d be sent back to this hospital. One morning, Sister Immaculata, our teacher, announced that Richard had died. His High Solemn Requiem Mass was one of the saddest experiences of my childhood.

While I’m sure that the big city hospital in question was a much better place years ago, it’s almost a certainty that long time employees there even at that time suffered from the same condition that’s prevalent among hospital personnel today: occasional bouts of medical callousness.

Like it or not, a basic callousness to human suffering comes from working in a hospital environment for too long a time. Hospital workers may not even be aware of what has happened to them in this regard, either.

During my time as an operating room orderly at age 21, I witnessed many things: Nuero- surgeons talking about their weekend golf outings as they drilled through a patient’s skull, or as they dug deep with gloved hands into a man or woman’s abdomen. Some surgeons were like temperamental opera divas or restaurant chefs. If an action of a scrub nurse displeased them, they might throw a set of forceps across the room, or kick one of the floor waste buckets (they were on wheels) so that it went rolling across the room and slammed into a portable X-ray machine. Other surgeons screamed that they wanted "Nurse so-and-so to get the hell out." Sometimes the surgeon in question would walk out of the room himself (there were only a few female surgeons, but only the males had problems with their temper). I don’t know whether this "walking off stage" ever put a patient’s life in jeopardy. My guess is that most often it did not because there was always a resident (in scrubs) ready to take over when a surgeon misbehaved. Residents, in fact, were almost always on hand to observe and then, when asked, try doing the operation themselves.

During most operations, the surgeon would do the opening incision and then maybe stick around for a few exploratory "digs," but once the work became "mechanical," an assistant would take over. The surgeon almost never hung around as the patient was being stitched up before the transfer into the recovery room. At this point they were already in the surgeon’s lounge or in the small doctor’s lounge having a cup of coffee and eating a sticky bun.

The stresses of meeting the demands of diva surgeons meant that many scrub nurses were ready for a laugh, and this sometimes took a bawdy turn, such as when a nurse or two would steal a peek under the cover sheet when an especially good looking young man was fast asleep on the operating room table. While these were very unethical peeping tom moments, I witnessed their occurrence time and time again and wondered what the guy who was being looked at would do or say if he knew what was happening.

As an OR orderly, I was expected to open all the operating rooms at 6:30 AM, set up the IV stands in the individual curtained cubicles and retrieve the patients for 8 AM surgery from the hospital’s upper floors. It was a huge responsibility. If an OR orderly was squeamish about blood and guts, there were only two options available: quit, or find a way to get used to the gore.

My job included taking specimens to pathology, including aborted fetuses from the many therapeutic abortions preformed at the hospital. As a twenty year old I didn’t give too much thought about these procedures. I naively assumed that the abortions were performed to save the life of the mother until I got talking to an Eastern Orthodox nurse who said that this was not the case at all. She also told me that she was on record as refusing to assist in these "therapeutic acts of murder." While I admired her for having the courage of her convictions, it made me wonder about all the Irish Catholic nurses (this was Boston, after all) who didn’t seem to have any issues with abortion, but who would look very, very distressed when handing me the little fetus jars to take to pathology.

These quick, guilt-ridden "exchanges" reminded me of Pontius Pilate washing his hands of the situation.
Mastectomies and amputations affected me the most, especially when a scrub nurse would put a still warm, wrapped in blue linen amputated leg in my arms, and ask me to deliver it to the morgue.

Of course, when a patient died on the operating room table, the mood in the room turned solemn. Many scrub nurses became upset. Some actually cried. The nurses were the ones who felt a death the most. The surgeons, for the most part, were stoned faced. It was hard to know what they were feeling. It was always the nurse or the orderlies who stayed behind and cleaned up the room and washed the body of the deceased. For me, a death in the OR was always a shock, especially if I was the one who had escorted the patient to the operating room earlier. Times like this, I’d think back and try to remember if the patient had said anything of note, or whether their behavior pointed to a premonition regarding their own death.

After the washing of the deceased’s body, an orderly’s help was needed in moving the man or woman onto a special stretcher for the trip to the morgue. The silence in the OR room at this time was profound. People spoke only if necessary. There was certainly no talk of golf, or how great it would be to get drunk at the after work happy hour at the local pub.

Wheeling the stretcher with the covered up corpse on it to the elevator nearest the operating room, and then getting to the basement morgue without anybody else coming on the elevator was hardly a guarantee. There’d be no emotional reaction if a nurse, doctor or resident got on the elevator at different floors, but if a non-medical visitor to the hospital saw the stretcher, he or she would step back as the blood would seem to drain from their faces.

In conclusion, I’d say that long time hospital experience can either plunge you into a river of callousness, from which it may be difficult to return, or it can work to increase your human empathy skills. I don’t know where into which category I fall. I like to think it’s the latter, but who knows.

Decades after my job in the OR, I still have dreams of wheeling stretchers down long antiseptic corridors and of bumping into surgeons in masks, who may or may not be holding a pair of forceps.